Network Contract DES Contract Specification 2024/25

Network Contract DES Contract Specification 2024/25

The NHS England document this support article relates to was published on 28th March 2024

What do I need to know?

Reducing IIF indicators from 5 to 2

All of the vaccine related IIF indicators have been removed, leaving the Learning Disabilities and FIT indicators.  The funding released from these indicators has been moved into the Local Capacity and Access Improvement payment.

Local Capacity and Access Improvement Payment

This is explored in much more detail in the separate document Part B: Non Clinical for which we have created a separate support article.
This funding is in addition to the Capacity and Access Support Payment and relates to improvements within key components of Modern General Practices Access (MGPA) as described in the Delivery Plan for Recovering Access to Primary Care.  This includes:
  1. better digital telephony
  2. simpler online requests
  3. faster care navigation, assessment and response

Clinical Director changes

Changes to responsibilities/accountability of Clinical Directors

The document makes changes to the responsibilities of the Clinical Director as follows:
A PCN must have in place a Clinical Director who is responsible for:
  1. Ensuring the PCN delivers the requirements set out the NCDES by
    1. Effectively allocating the funding and ARRS capacity to deliver the requirements of the NCDES
    2. Deployment of the Capacity and Access Support payment to ensure all practices in the PCN are
      1. operating the Modern General Practice Access Model and are continuously working to improve patient experience
      2. informing the Comissioner of PCN delivery against the Local Capacity and Access Improvement Payment criteria
      3. working with local partners to support establishment of Integrated Neighbourhood Teams and ensure PCN participation within its INT

Clinical director, PCN leadership and managment funding changes

The funding for all of these areas has been joined together and given to the PCN as core funding, giving greater flexibility in how this funding is used.

New roles eligible for ARRS staffing

  1. The PCN can recruit other direct care, non-nurse and non-doctor Multi-Disciplinary Team roles, if agreed with the commissioner.
  2. The PCN can employ additional Mental Health Practitioners with 100% reimbursement
  3. A PCN can now employ one WTE Enhanced Practice Nurse (2 if PCN >100,000 patients)

Change in the Service Requirements

Last year there were multiple Service Specifications which were non-contractually binding:
  1. Access
  2. Medicines Optimisation
  3. Enhanced Health in Care Homes
  4. Cardiovascular disease prevention
  5. Early Cancer Diagnosis
  6. Health inequalities
  7. Social prescribing
Each of these had their own detailed service specification.  This has been significantly simplified and all Service Requirements are described within this document in Section 8.
There are four key functions described:
  1. Co-ordinate, organise and deploy shared resources to support and improve resilience and care delivery at both PCN and practice level
  2. Improve health outcomes for its patients through effective population health management and reducing health inequalities
  3. target resource and efforts in the most effective way to meet patient need which includes delivering proactive care
  4. collaborate with non-GP providers to provide better care, as part of an integrated neighbourhood team
This is explored in much more detail in the separate document Part A: Clinical and support services (section 8) for which we have created a separate support article.

The introduction of Integrated Neighbourhood Teams (INTs)

The introduction of the term Integrated Neighbourhood Team is seen in this document this year.  This highlights that Primary Care Networks form an important part of wider Integrated Neighbourhood Teams.  The key aim is for PCNs to forge closer links between practices, the broader health and care system and a diverse range of partners in their communities, including the volountary sector and patient groups for the benefit of patients.  A Neighbourhood team is formed when cross-sector teams come together, typically at a neighbourhood level, serving approximately 30-50,000 patients to share responsibility for supporting the health and wellbeing of a community.

Supervision of Physician Associates

It is clarified that Physicians Associates provide first point of contact this must only be where their named GP supervisor is satisfied that adequate supervision, supporting governance and systems are in place.  The GP supervisor must take into account a Physician Associate's knowledge, skills and experience gained through their training and development.  The guidance has also been updated to stipulate there must be appropriate debriefing of patients.

Ending PCN reallocation of unclaimed funding

Previously unclaimed funding for PCNs could be reallocated.  This has ceased in this iteration of the contract.

Requirement for submission of data for Workforce

There is a new requirement (5.4.9) for the PCN to submit any data required by NHSE for the purposes of NHS England Workforce Collection (including ARRS).  The PCN must appropriately code, review and update data required for the Workforce Minimum Dataset at least monthly in accordance with the standards set out in guidance published by NHS England.